title: Clinical applications of dosimetry for mIBG therapy.
abstract: Metaiodobenzylguanidine (mIBG), developed 30 years ago, is taken up by tumours expressing the noradrenaline transporter. Radiolabelled with I-123 or I-131, mIBG has become a gold standard for diagnostic imaging of pediatric and adult neuroendocrine cancer. Within a few years of its clinical introduction, I-131 mIBG was found to be an effective palliative treatment with minimal toxicity that in some cases could produce a complete response. The importance of internal dosimetry for I-131 mIBG therapy has been demonstrated by a number of studies showing that absorbed doses delivered to tumours and organs-at-risk from standard and weight-based activities can vary by an order of magnitude. However, significant correlations between the whole-body absorbed dose and myelotoxicity have been demonstrated and studies based on this relationship have enabled treatments to be tailored to the individual. Ongoing developments include patient-specific treatment planning based on tumour dosimetry and cocktails of radionuclides and radiosensitisers.
authors.affiliation: Joint Department of Physics, Royal Marsden NHS Foundation Trust & Institute of Cancer Research, Sutton, Surrey, UK. glenn.flux@icr.ac.uk
authors.forename: G D
authors.initials: GD
authors.lastname: Flux
authors.forename: S J
authors.initials: SJ
authors.lastname: Chittenden
authors.forename: F
authors.initials: F
authors.lastname: Saran
authors.forename: M N
authors.initials: MN
authors.lastname: Gaze
mesh_terms: D019797:3-Iodobenzylguanidine / Q000008:administration & dosage / Q000627:therapeutic use*; D000328:Adult; D002648:Child; D006801:Humans; D007457:Iodine Radioisotopes / Q000008:administration & dosage / Q000627:therapeutic use*; D018358:Neuroendocrine Tumors / Q000000981:diagnostic imaging / Q000532:radiotherapy; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000008:administration & dosage / Q000627:therapeutic use; D011880:Radiotherapy Planning, Computer-Assisted
chemical_list: D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine